Defibrillation by strong electric shock is the only known procedure that reliably terminates ventricular fibrillation (VF). Implantable cardioverter-defibrillators (ICDs) have recently been implanted with increasing frequency in the pediatric population and in patients with congenital heart defects (CHD). In these patients, it is often not indicated or even impossible to implant a transvenous lead ICD because of the patient's small heart size and congenitally altered anatomy, thus non-standard ICD configurations have to be used. Such ICD configurations commonly involve individualized epicardial or subcutaneous lead placement. However, there is currently no reliable, personalized way of predicting which ICD configuration would have the lowest defibrillation threshold (DFT) and cardioversion threshold (CVT) in a patient. A low DFT is desirable because strong electric shocks damage cardiac myocytes, increase mortality, and can cause pain and psychological trauma. Thus, it is important to be able to predict the optimal ICD configuration for a specific patient (i.e., a configuration exhibiting a low DFT and CVT), especially in the case of a pediatric and/or CHD patient if a transvenous lead ICD configuration cannot be used.
It would therefore be advantageous to provide a method for computationally determining defibrillator lead and can placement in the heart.